RN1485

This is my first time renewing with Alabama. I completed all of my CEUs with NetCE. They state on their website that they report to the board hourly. It's only been a few days but it's still not showing up. Does it usually take a while to post? The board says to not enter the CEUs from an approved provider manually.

Has anyone gotten endorsed by the GABON and not used the employment verification forms that they have provided. Everything about the process is so old. Paper application and having to submit these forms. No one uses forms anymore and the last time I called my previous HR department for employment verification, they wouldn't even talk to me. They just directed me to a third party site. I feel like the process should be easier than this.

Hello! I have been offered a job for an inpatient nurse case management position. Strictly discharge planning. No your. I have an upcoming interview for an outpatient oncology practice as a nurse navigator. I think I’d like the role of the navigator position more because of the rapport you build with patients as well as having an interest in oncology. However, I’m wondering if the first position would be better in terms of a stepping stone. I don’t have inpatient CM experience and have found it difficult to get hired in a hospital position. Anyone have any thoughts on either positions? Thanks!

If you want to be an FNP, clinic nursing is the way to go! I work in a public health clinic as a nurse case manager. However, there are times when I have to help the nurse practitioner with physicals, pap smears, and std treatments-as in I do them all by myself. I can order select medications via nurse protocol without a doctors order. I’ve gotten very comfortable doing an H&P. The only reason I am able to do this is because I work as an expanded role RN. Some states have this because there is such a shortage of practitioners in public health. I feel like being in the clinic would better suit your career goals. Plus, you could get hired in the clinic if they know you are planning to go back to get your FNP.

When I first read the title of your post, I thought well my friends send me pics of their surgeries or wounds or ask for medical advice LOL. I have this internal conflict because, at times, it seems I have no peace and I’m not living in the moment, but the future. I’m always trying to find new nursing career opportunities to pursue. I like continuously learning and obtaining certifications. I’ve never not had a goal in my mind that I was working towards. I’m married, but I decided not to have kids. It’s just not something I wanted to do or was passionate about. Some people are driven to be just a mother or father. Some people are driven to have both, but I do think one supersedes the other and maybe even flip at different times of life. Some people only want to focus on their career. I knew if I had kids, they would take a back seat to my career goals and aspirations. Not really fair to them or me.

My first nursing job on the floor I left after 3 months because it was a toxic work environment without much support. I didn’t even put in my notice. I ran out of there screaming!! Tried other nursing positions (psych) until I decided to try the floor again and the support was so much better. It can seriously make or break you! Also nursing roles build on top of each other. The meds you are calling in refills on eventually you’ll know all about those and why they are given. You can really learn a lot from the doctors as well on different neurological conditions. Everything you learn in a nursing position, you take with you to your next position. I knew right away bedside wasn’t where I thrived because I don’t like feeling rushed. It felt like a waitressing job and I didn’t thrive when I was a waitress either. I don’t like codes or emergency situations. I like to build a report with patients and take my time. That’s just me. Do what makes you happy! Don’t worry about what other people think you “should” be doing. You’ll be miserable if you do!

This is interesting because I am on the flip side working as a public health nurse case manager (they actually tie in nicely with each other) wanting to get a job as a case manager for an insurance company. I actually have a second interview for a telephonic case manager on Friday. I’m having second thoughts though because of the metrics and micromanagement that you posted about. Public Health can be very rewarding and I really do love my job. I’m rarely micromanaged and we are responsible for maintaining our training so we are up to date with everything. We have audits but it has never been stressful. However, pay is abysmal!! And I feel the same as you that there aren’t many growth opportunities. In my state there is no pay raise, no tuition reimbursement, and rarely any promotional or lateral opportunities. You could probably start higher on the totem pole since you have an MSN in public health with several years experience. I do feel like I’m actually helping people and it’s not so focused on the bottom dollar. The work life balance is nice with government holidays, etc. Feel free to message me if you want if you have any public health questions.

I’m just now seeing this! LOL! Too funny ?

Right, I’m use to behavioral questions too. This was just super weird!

Both of the interviewers were nurses and yeah the questions weren’t hard, but my brain wasn’t functioning and I choked! I thought I was going to have a discussion about the job and how my experience could benefit them, not an oral pop quiz on medical terminology!! ? I stopped them midway through and was like look we can stop this if you want, it’s obvious I’m bombing this interview LOL.

Hello, I’ve been away for a while, but I wanted to share a humiliating experience to see if anyone else has had something similar happen. For the past 3.5 years I’ve been working as a CM in an outpatient setting. Got my CCM in September so I wanted to start looking at new career possibilities. I’ve had 3 interviews this past week for a position in case management/utilization review. Normally, when I interview, I get a lot of fluff questions and situational questions. Those I am use to. However, I interviewed for an insurance company yesterday and holy hell I thought I was on a game of jeopardy. Here is an example: what does MRI stand for and what is it? What does CT stand for? What’s the difference? What is a carotid endarterectomy and who performs it? What is a CABG? What is hepatic encephalopathy? What the eff?! I was so flustered and totally unprepared that I literally could not think of what an MRI stands for! I said medical resonance imaging! ?‍♀️ I couldn’t think of what encephalopathy was! So I guess my question is, is this typical for an insurance company to ask these types of questions? I kind of get why they did, but damn! Anyways, thanks for reading my rant!

Palliative gets consulted and usually sends pts home or to inpatient hospice but doesn't always write new orders to make the patient more comfortable and a lot of them don't make it by the time hospice is ready.

I have maybe one I can ask this weekend at work but they want one personal and two professional on letterheads and signed. I emailed her back to let her know that I may not be able to provide them at the interview but could provide names and numbers. No one likes the idea of writing letters of recs. It's time consuming to write a thoughtful one. That's why adequate time to write one is needed. Ugh

Thanks for your response. Even though you work peds, it's definitely applicable to my situation. Sometimes (I've noticed) that many of these pts don't have a central line. The physician doesn't want to have one put in so no TPN. No tube feeding. Still getting IV fluids. Fluid volume overload. No foley for comfort care. I just feel like there has to be a better way for our unit to take care of these patients.

This job that I am interviewing for next week wants 3 letters of recommendation. Not just a list of names and numbers. I just set up the interview today and she emailed me things I needed to bring to my interview early next week. It usually takes months for people to get those when applying to grad school. This isn't even a new grad position either. So weird. I literally have 4 days to ask people to write me a recommendation. 😖

Hello, Ive been working on an ortho/surgical floor for almost a year now an occassionally we will get overflow patients (a lot of them oncology with DNR) who are at the stage where they may need to be on hospice. Usually when our doctors consult our hospice doctor, the patient is deteriorating to the point where they may not even make it to hospice. Anyways, my question is at that point, how much are you intervening as a nurse? Are you just trying to make them comfortable with pain meds/anti-emetics, repositioning? What if they have poor oral intake or decreased urinary function? Do you advocate for tube feeds or catheters? I apologize for my ignorance. I just want to know the best way to care for them as I'm starting to see more on our unit.

Thanks so much for your input. It's definitely something I want to do, but very uncertain where things are headed with the new administration.

Hello, I've been a nurse since 2014. Most of my experience has been in psych nursing. However, right now I've been working on a medsurg floor for about 9 months. Once I hit my year mark, I'll prob be looking into something else as medsurg is not for me. I'm really interested in public health nursing and would like to pursue it, but I'm worried about budget cuts being an issue with job security. Have any of you experienced a lot of lay offs d/t being in public health? Any info on GA department of public health in particular? Additional info on just pros and cons of the job would be greatly appreciated! Thanks!

Thanks again for all the responses. Truth is there is no end game in mind. My goal when I started nursing school was to become a whnp. I like the gyn part the best. I didn't have the best mother-baby experience during clinicals and I'm no exactly a natural around babies, so I decided to find something else that interests me. I found that I have always been interested in psych and was thinking of psych np. However, being interested in psych and actually taking care of psych patients are two different things. I don't even know if I want to be an NP anymore because I see what doctors deal with and it just doesn't seem appealing. So now I have no clue. I want to do medsurg or something similar like ortho or oncology to help me figure out what my interests are as well as be more marketable to other jobs. I just don't want a repeat of the cardiac floor. These people were always having to get transferred to the ICU or have rapid responses called on them because they were so sick. I just want a place where I can practice my skills and time management without pts getting rapids called on them every night, if such a place exists.

Thanks for responding! Yeah a lot of the nurses at work did at least a year of med-surg before coming to psych. All of them say how beneficial it was and recommend getting some med-surg experience.

Hi all, So I've been a psych nurse for a little over a year now and I'm really looking for a change. I feel like I should get some medsurg experience because all the job postings that I'm interested in seem to want some sort of acute care experience, plus having that foundation would be a huge plus. The problem is the last time I worked in medical was a complete nightmare. It was a cardiac step down and I only lasted 4 months. I was miserable. I cried every time I went to and from work. I don't hate where I work now the way I hated cardiac, but it's just not very fulfilling. I know I'm not an adrenaline junkie. I even hate psych emergencies when they come up, but prefer them over dying patients. (In cardiac I felt like my patients were circling the drain every shift). So should I try medsurg to be more marketable to other opportunities? Or should I just stay in psych and just maybe switch jobs? Are there other jobs out there that would accept psych experience as valuable experience? Other areas I've thought about include: public health, mother baby, and case management. Some of these do say they prefer acute care experience. Im worried about the horrific poor staffing that I hear about medsurg as well as a repeat of my past experience in medical. Thoughts? Thanks!

1:1 is definitely ideal but not realistic where I work. Most days I work as the only nurse on the unit where I have to chart on everyone as well as do care plans on top of the admissions I'm getting. Sometimes the only time I can talk with them is during med pass and even then I feel like I can't give them 100% of my attention because I'm constantly being interrupted in some way. Always understaffed!

I've been a nurse for about a year now and have been working psych for the past 6 months. I'm really considering going back to school (after I'm done with my RN-BSN) to become a PMHNP. I do have some reservations about it though. Before I spend $$ on grad school, I want to know if it's worth it. By worth it, I mean is it better than being a staff RN? For the longest time I thought I hated nursing even psych nursing which I like better than other areas, but now I realize really I just hate the way the administration treats nurses. Short orientation. No raises. No caps on patient to nurse ratios. Always understaffed with unsafe practices. It's exhausting and mentally taxing. Why do I want to become a PMHNP? I have always found psych very interesting with a lot of critical thinking involved. It would be nice to have more autonomy with the patient's treatment. Positive patient outcomes would be rewarding because you helped them improve. I know there isn't a perfect job with no stress however it would be nice to know that it gets better as you climb the ladder. Any feedback would be appreciated.

Where do you work?! That sounds amazing!

I looked into my organization's policy and all I could find was that doctors who order involuntary medications have to have another doctor agree with him from 72 hours to 30 days (up until 72 hrs he makes his own decision) with a review with the treatment team every week. From 31-60 days he would need two physicians concurring with him on forced meds. At the end of 60 days, the physician would need to set up a clinical review. Not sure if that involves forensics or not but I didn't see any additional info regarding forensics.